<!DOCTYPE html>
<html xmlns:wicket="http://www.w3.org/1999/xhtml">
<head>
</head>
<body>
<wicket:extend>
    <form action="" wicket:id="form">
        <fieldset>
            <legend>
                <wicket:message key="queryPersonPage.title">[page.title]</wicket:message>
            </legend>
            <table>
                <tr>
                    <td>
                        <table>
                            <tr>
                                <td><label for="country">
                                    <wicket:message key="person.country">[person.country]</wicket:message>
                                </label></td>
                                <td><select id="country" wicket:id="country"></select></td>
                            </tr>
                            <tr wicket:id="patientIds">
                                <td><label wicket:id="idLabel">[person.id]</label></td>
                                <td><input type="text" AUTOCOMPLETE = "off" wicket:id="idTextField"/></td>
                            </tr>
                            <tr>
                                <td colspan="2" align="right">
                                    <input type="submit" name="queryButton" id="submit" wicket:id="submit" wicket:message="value:form.button.search">
                                </td>
                            </tr>
                        </table>
                    </td>
                    <td>
                    	<div class="prescriptionlinks"><a wicket:id="helpLink"><span wicket:id="helpLabel">[bla]</span></a></div>
                        <p wicket:id="countryInfo">[country specific text]</p>
                    </td>
                </tr>
            </table>
        </fieldset>
    </form>
    <div wicket:id="personInfoModalWindow">[PersonInfoModalWindow]</div>
    <table wicket:id="dataTable" class="dataview">[dataTable]</table>
</wicket:extend>
</body>
</html>
